Changes in Cardiac Sympathetic Nerve Innervation and Activity in Pathophysiologic Transition from Typical to End-Stage Hypertrophic Cardiomyopathy

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FIGURE 1.
Polar map of LV myocardium was divided into 20 segments as shown, and uptake and washout rate in each section were determined.
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FIGURE 2.
Early uptake ratio and washout rate of ¹²³I-MIBG in control group and in groups of patients with HCM.
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FIGURE 3.
Polar maps depicting differences in relative ¹²³I-MIBG early uptake between groups of patients with HCM. Ant = anterior wall; Lat = lateral wall; Post = posterior wall; Sept = interventricular septum.
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FIGURE 4.
Polar maps depicting differences in relative ¹²³I-MIBG washout rate between groups of patients with HCM. Ant = anterior wall; Lat = lateral wall; Post = posterior wall; Sept = interventricular septum.

TABLE 1

Baseline Characteristics of Patients with HCM

Characteristic	Group A	Group B	Group C	P
Patients (n)	28	9	9
Male patients (n)	20 (71%)	5 (56%)	5 (56%)	0.2539
Age (y)	48.8 ± 14.0	56.8 ± 9.5	60.7 ± 8.5	0.6560
Patients in NYHA class III/IV (n)	1 (4%)	4 (44%)	7 (78%)	<0.001
Echocardiography findings
IVST (mm)	18.4 ± 3.4	13.9 ± 5.6	11.2 ± 3.3	<0.001
PWT (mm)	12.3 ± 2.8	12.3 ± 2.5	10.4 ± 0.9	0.1483
MWT (mm)	18.7 ± 3.5	15.1 ± 4.3	12.2 ± 2.1	<0.001
LAD (mm)	39.1 ± 6.0	44.0 ± 9.1	44.8 ± 9.6	0.7110
EDD (mm)	44.8 ± 4.9	49.4 ± 5.0	60.3 ± 5.5	<0.001
ESD (mm)	25.7 ± 5.0	37.6 ± 3.3	51.6 ± 6.0	<0.001
FS (%)	42.8 ± 8.8	23.9 ± 4.3	14.7 ± 3.9	<0.001
Patients receiving β-blocker (n)	6 (21%)	1 (11%)	3 (33%)	0.5194

NYHA = New York Heart Association; IVST = interventricular septal thickness; PWT = LV posterior wall thickness; MWT = maximum LV wall thickness; LAD = left atrial dimension; ESD = LV end-systolic dimension.

TABLE 2

¹²³I-MIBG Scintigraphic Data

↵* P < 0.05 vs. control.
↵^† P < 0.05 vs. HCM with normal LV systolic function.
H/M = heart-to-mediastinum uptake ratio; WR = washout rate; regional EU = number of segments with significantly reduced early ¹²³I-MIBG uptake compared with control group; regional WR = number of segments with significantly increased ¹²³I-MIBG washout rate compared with control group.